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Is HPV Vaccine Benefit Exaggerated?

Experts Debate Whether Gardasil Marketing Clouds Risk/Benefit Decision

HPV Vaccine, Pap Screens, and Cervical Cancer continued...

Haug notes that the U.S. women who get cervical cancer are those with the least access to health care. Those who get regular Pap tests, she says, are unlikely to get cervical cancer even if they don't get vaccinated against HPV.

"We already have a way of preventing cervical cancer -- that is a major point, at least for those of us lucky enough to have health care and use it. So this can be prevented without the vaccine," Haug says.

That's not entirely true, says Haupt.

"While Pap screening is a very important intervention, it is not perfect. Not all women get Pap testing, and not all women who get Pap tests will have their lesions found," Haupt tells WebMD. "And even with 50 years of Pap testing, we see 30 cases of cervical cancer a day in the U.S. Vaccination is another tool that together with Pap screening will contribute to cancer prevention. Neither one works as well without the other."

"We still have people dying of cervical cancer here in the U.S.," Englund says. "It is easy to say we can prevent cervical cancer with Pap screening, but people are not getting Pap screens: minority women, our native people, poorer people. So when you talk of risks and benefits, people must realize that some don't have the benefit of having the wonderful health care I enjoy because I have health insurance. But they still have the risk of cervical cancer."

Gardasil Risk

A CDC report -- appearing in the in the same issue of The Journal of the American Medical Association -- summarizes adverse events associated with Gardasil from its June 2006 approval through December 2008.

The report finds only one major safety issue worthy of further study: There might be a higher-than-expected number of blood clots in women who received the vaccine.

Study leader Barbara A. Slade, MD, a medical officer at the CDC, notes that the reports do not prove a link between the vaccine and adverse events. The reports do, however, point to potential risks that require further study.

"This is something worth looking at," Slade tells WebMD. "Now nearly all the people with blood clots had one of the known risks: estrogen birth control, obesity, one of the genetic mutations that puts you at risk. Most had one if not more than one of these risks."

Further study will be needed to show whether these blood clots are actually caused by the vaccine; such studies already are under way.

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